Macmillan-CABx Cancer Patient Services

– in the Scottish Parliament at 5:00 pm on 9 October 2003.

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Photo of Trish Godman Trish Godman Labour 5:00, 9 October 2003

The final item of business today is a members' business debate on motion S2M-166, in the name of Karen Whitefield, on Macmillan-citizens advice bureaux cancer patient services. The debate will be concluded without any question being put.

Motion debated,

That the Parliament congratulates Macmillan Cancer Relief and the citizens advice bureaux of Lanarkshire on the innovative service that they have developed for cancer patients, providing debt assistance, employment, housing and other benefits to cancer patients and their carers; recognises that this is an excellent example of effective partnership working between voluntary organisations; commends Macmillan Cancer Relief and Airdrie Citizens Advice Bureau on the success of the pilot project in Airdrie; wishes them well as the project is rolled out across Lanarkshire, and recognises the benefits that such a service could provide across Scotland.

Photo of Karen Whitefield Karen Whitefield Labour 5:08, 9 October 2003

I welcome this opportunity to highlight the excellent work that is being carried out by Macmillan Cancer Relief and citizens advice bureaux in partnership. I am proud that the service was first piloted in Airdrie in my constituency and am pleased that it has been expanded to cover all Lanarkshire. I firmly believe that it should be expanded throughout Scotland.

Following an informal conversation with Ian Gibson, who is the Scottish director of Macmillan Cancer Relief, I was made aware of the difficulties that cancer sufferers and their carers face in obtaining advice on a range of issues. I suggested that he should contact the manager of Airdrie CAB, Eileen McKenna. Together, they developed a pilot project that has now been expanded throughout Lanarkshire. It is not often that such problems can be solved so quickly and effectively merely by putting two people in touch with each other, although perhaps those people have not viewed the process as being so easy.

Many—if not all—members in the chamber this evening will have been touched by the effects of cancer. In Lanarkshire, where the project is running, around 10,000 people suffer from cancer. Each year, a further 3,000 are diagnosed with the disease. Whether through personal experience or through supporting a friend or relative, we all know that coping with cancer is a dreadful and wearing experience. Financial pressures, which can result from the fact that cancer sufferers or their carers have to leave work, come at a time when families are least able to cope. For many people, this will be their first encounter with the benefits system, which is complex and difficult to understand at the best of times. They may also find that for the first time in their lives they are unable to pay their bills or repay their loans.

That is where Macmillan Cancer Relief and CABx can play a vital role. Project workers will visit cancer sufferers and their carers and provide a benefits check to ensure that they receive everything to which they are entitled. The workers will also provide support and advice on rearranging debt and on employment and housing issues.

I regard the Macmillan Cancer Relief-CABx partnership as an excellent example of how the voluntary sector can respond quickly to needs at a local level. Both agencies have unsurpassed expertise in their fields and the services that they provide are complementary. Also important is the fact that both agencies are well known to and respected by members of the public.

It is important to stress that the cancer patient service is not for cancer sufferers only; it is also for their carers. Carers can face considerable pressures—emotional, physical and financial—and they often need as much support as cancer sufferers do. They may face personal dilemmas such as wanting to leave work to care for a loved one but feeling that they are financially unable to do so. For the first time, they may be left with the responsibility for household finances, at a time when the household income has dropped. It is vital that carers understand and can access the range of support services and benefits that are available to them.

There is some evidence that increased stress can have a detrimental impact on the immune system. Reducing the stress that is caused by financial difficulties ensures that the sufferer is given every chance of remaining as healthy as possible and is in the best position to fight their cancer.

The project also provides bereavement visits to carers and families. For example, one woman who had lost her husband wanted to reduce her working hours so that she could spend some much-needed additional time with her children. She had worked out that that would cost her about £80 a week—a sum that she could not afford to lose. However, an interview with a project worker established that, as a result of various benefit entitlements, the women would be only £20 worse off—a price that she believed was worth paying, as it allowed her to stay at home with her children a little longer. That simple but effective piece of assistance clearly demonstrates the benefit that the cancer patient service can provide to sufferers, carers and their families.

I am convinced that the partnership between Macmillan Cancer Relief and CABx is working in Lanarkshire. I am equally convinced that it should be available to people throughout Scotland. In a press release on Tuesday, the Minister for Health and Community Care, Malcolm Chisholm, stated:

"There are undoubtedly initiatives across Scotland that can be adopted and adapted for local use. There is no point in starting from scratch if patients can benefit from experiences elsewhere and from changes that have already proven their value. We want to see best practice".

I am pleased that the minister is here tonight to allow me to remind him of the comments that he made on Tuesday. I hope that he will agree that the Macmillan Cancer Relief-CABx project is very valuable and could be expanded across Scotland. I call on all major players involved, including the Scottish Executive, local health boards, local government, Macmillan Cancer Relief and citizens advice bureaux to do everything in their power to ensure that all the people of Scotland can benefit from this excellent initiative.

Finally, I take this opportunity to congratulate the staff and volunteers who have helped to make the cancer service such a success—I am particularly pleased that Eileen McKenna is in the gallery tonight. Their commitment and dedication ensures that cancer sufferers and their carers receive support and advice at exactly the time when they most need it. They are providing a community-enhancing service that is second to none. I urge other members to speak in support of the service tonight.

Photo of Shona Robison Shona Robison Scottish National Party 5:15, 9 October 2003

I congratulate Karen Whitefield on securing the debate. I join her in paying tribute to Macmillan Cancer Relief and Citizens Advice Scotland, not only in Lanarkshire, but throughout Scotland, where staff and volunteers work hard to provide good services.

The project that has taken off in Lanarkshire is a coming-together of skills to ensure that patients get the best service. It seems obvious that such a coming-together and provision of good services would be good for patients. It is great to see the service developing in Lanarkshire, but I would like it to extend throughout Scotland. I am sure that it would benefit patients throughout Scotland just as it does patients in Lanarkshire.

The case studies provided by Citizens Advice Scotland show that the time when people have the medical worries that cancer brings is often also the time when they have financial worries. We cannot alleviate the physical problems resulting from cancer and the difficult treatments that are required, but we can alleviate the psychological worries and financial concerns that a family faces because of a diagnosis of cancer. That is what, I hope, this project achieves and I would like that to happen in the rest of Scotland.

I note that Citizens Advice Scotland talks about its services in other health settings. Working with Macmillan Cancer Relief is just one example of the increasing role that Citizens Advice Scotland has in the health setting. I would like that role to be extended. We talk about joined-up working but, to make it real, we need such innovative ideas. In this case, the initiative was taken by Citizens Advice Scotland to ensure that patients get advice and information when and where they require it. Patients need that advice and information as soon as they have been diagnosed, not weeks or months later. It is important that Citizens Advice Scotland is prominent in the health setting, whether in primary care or in the hospital. Where patients are is where they should be able to find appropriate financial advice and assistance. We are talking about advice and information not just on financial matters, but on employment, housing and the other areas in which Citizens Advice Scotland has practical expertise.

Such initiatives are a growing area of work. As Karen Whitefield, there is a huge requirement for support. There is the rub. In order for Citizens Advice Scotland to expand its services so that everyone in Scotland can access free, independent advice at times of ill health, it will require resources. That is not just up to the Scottish Executive; it is up to Citizens Advice Scotland, the health boards and local councils. However, the Executive has a key role in pulling everything together. I am sure that, if it says that it is willing to put in the resources to ensure that the model is introduced throughout Scotland, others will follow suit, fall in behind and put their money where their mouth is. I hope that the minister will give us a commitment on the matter tonight.

Photo of Trish Godman Trish Godman Labour

To ensure that all members who requested to speak have a chance to do so, I ask that speeches be kept to four minutes.

Photo of Donald Gorrie Donald Gorrie Liberal Democrat 5:20, 9 October 2003

I am sure that there will be no dissent over such a brilliant idea, which reflects great credit on the CABx in Lanarkshire—I think that there are nine of them—the Macmillan nurses and Karen Whitefield, who has promoted the service and secured this debate.

We can copy the model on which the service is based in many other spheres of our lives. In that model, people who can do one thing co-operate with another bunch of people who can do something different. For example, Macmillan nurses are brilliant at dealing with cancer but know nothing about the benefits system. As a result, instead of wasting their time struggling with forms that they do not really understand, they get the CAB to do that work. The CAB people, who have an amazing range of knowledge about money and all sorts of problems but know nothing about clinical health issues, can deal with the benefits side of the matter and leave the nurses to deal with the clinical aspects. Although the idea is simply common sense, it is the sort of thing that we do not do.

Lots of people spend time filling in forms that they do not understand. The benefits system is a particular nightmare in that respect. My cleverer colleagues might understand it, but I always rely on my excellent assistant in such cases. Once I get the required details from the person with the problem, she sorts out how I go should about sorting the problem out. However, the CAB people really understand the benefits system and can help the patient. As a result, the service is a marvellous use of people's time. It is obviously beneficial to patients, who can get all their benefits worries sorted out, and it is very good for carers, who often do not know about the help that they can get. The various case studies in the paper that the CABx have produced demonstrate the service's huge financial and emotional benefit to individuals.

As other members have said, we should spread this brilliant idea across Scotland, because everyone should benefit from it. Indeed, a Macmillan nurse in Lanarkshire and the manager of a CAB in the area urged me to say precisely that. I hope that that can be done, because once things are all sorted out the service will not cost very much and will save lots of money. I urge the minister to do what he can to promote it so that we can all do what we can to get it up and running in our local areas.

Photo of Cathie Craigie Cathie Craigie Labour 5:23, 9 October 2003

Like other members, I congratulate Karen Whitefield on lodging the motion and securing this evening's debate. A survey that Macmillan Cancer Relief commissioned in 1999 showed that cancer patients, particularly in the Lanarkshire area, were worried about their financial future. They were worried that they would have to give up work, that they would not be able to provide for their family and that they did not know their way around the maze of the benefits system or where to start filling in the forms.

Patients and carers asked—and indeed are still asking—Macmillan nurses for help and advice on such matters. As highly trained professionals delivering palliative care to patients in their homes and in the community, the nurses realised that they could not offer advice about benefits, as they knew nothing about the issue. However, they also realised that such worries were affecting their patients' lives. Those people have enough on their minds without having to worry about money and the benefits system.

The success of the partnership between Macmillan Cancer Relief and the CABx in Lanarkshire is benefiting patients and their families. I thank the staff and volunteers from both organisations. I would also like to mention on the record Karen Whitefield's contribution to the partnership. We all know how she has promoted her constituency of Airdrie and Shotts, not forgetting—

Photo of Cathie Craigie Cathie Craigie Labour

That is what I was going to say.

In 1999, Karen Whitefield, as the youngest female MSP—I could say a swear-word now; I am sure that the other women present feel the same way—was asked by Macmillan Cancer Relief to be the first signatory to its voice for life campaign. She always had close links with her local CAB but, when she signed up to the campaign, her interest in Macmillan Cancer Relief increased. When she heard what the survey uncovered, she was quick to put the two organisations together.

As has been said, because of the success of the pilot scheme in Airdrie, the service is being rolled out and is delivering throughout Lanarkshire. The people involved with the CAB movement and with Macmillan Cancer Relief want to deliver the service throughout Scotland, but there is a lack of resources to do so. There is certainly not a lack of commitment from the staff and volunteers. I hope that the benefits that the people of Lanarkshire enjoy can be enjoyed throughout Scotland. I ask the minister to consider carefully the project in Lanarkshire and to put in motion the process that will allow the project to be rolled out Scotland-wide.

Photo of David Davidson David Davidson Conservative 5:27, 9 October 2003

I add my congratulations to Karen Whitefield. The project in Airdrie is a good example of best practice and partnership. I have a small local connection because I once had an office in Airdrie, although I did not operate in the surrounding villages.

The debate is important because it focuses on the fact that when people are ill, the illness is often not the only problem. As co-convener of the cross-party group in the Scottish Parliament on cancer, I have an interest in cancer, but the same point applies to all people who are ill, not just to those who have cancer. Through no fault of their own, problems can arise. The project is an example of best practice that could be rolled out throughout Scotland—I know that the minister is listening intently.

The partnership involves different organisations in the voluntary sector. Macmillan Cancer Relief and the CABx do excellent work, but they have limitations that arise from capacity and funding problems. We must consider how we can free up the Macmillan workers to deal with the care aspects and help CABx to deliver their advisory and advocacy role in Scotland. Members have received excellent briefings from the two organisations. The Macmillan Cancer Relief briefing mentions awareness of benefits, "access to information" and "receiving practical assistance". That encapsulates what the project is about.

I would like to widen out the issue and ask about the role of the health boards if we rolled out the project. I seem to remember that, in the dim and distant past, hospitals had people called almoners who advised patients on what help they could receive from the council with rent and other such matters. The health service seems to be slipping away from that role, which does not relate to the service's expertise.

How can we introduce the kind of support that we have heard about tonight to other parts of the system? That would involve not only the Scottish Executive, but also the Department for Work and Pensions and the Benefits Agency. Even though the benefits system is a reserved matter, all members receive queries and requests for assistance on the issue. I use the CABx a lot in that field because they have a particular strength in it. How can the two Westminster agencies, which use taxpayers' money from throughout the United Kingdom, deliver and support the people who can provide such a service? Should we perhaps look for the CABx to be able to receive lottery money or money on contract from those two agencies? That is a matter for Westminster to talk about.

The scheme could be rolled out across the whole UK, not just for cancer sufferers, but in other parts of health care. If that happened, what role would we have here, other than to offer our congratulations on an excellent project and to ask for more? How can we support such initiatives practically, and how can we get the Scottish Executive on board to play the role that it can play? How can we get the UK Government on board? It is unfair that the voluntary sector has to pick up the tab for the delivery of services that, in theory, are the responsibility of the various ministries that handle benefits and support—whether housing benefit or whatever.

I congratulate Karen Whitefield and the two organisations on the work that they have done. However, the issue should perhaps be pushed a little further than saying that we will leave it to cancer services and roll out services across Scotland where the CABx can afford to do so. We must lift the horizon and consider the model carefully, in the Health Committee and other committees of the Parliament as well as in the Executive, and consider how we can involve Westminster. The project is a shining example of what can be done through good partnerships in Scotland.

Photo of Christine Grahame Christine Grahame Scottish National Party 5:31, 9 October 2003

It has become a matter of form to congratulate members on their motions, but I genuinely congratulate Karen Whitefield on the pivotal role that she has played in bringing together these two groups of people. It is a simple idea, but the simple ideas are always the ones that some of us walk past. The word "partnership" is so overused and overexposed that we think, "Oh, it is just another partnership." However, this one really works and it is extraordinary what has come out of it.

I looked up some statistics on cancer and discovered that four in 10 of us will develop cancer at some point. Looking around the chamber, I find it extraordinary to think that of the 10 members who are here, four of us might develop cancer. Then there are the other debilitating illnesses that have been mentioned, which the service deals with. This year, some 25,000 people in Scotland will develop cancer. The disease changes a person's life; their priorities change, they are thrown into turmoil by thinking about their mortality and they are not in a position to consider the practicalities of life.

We all know how vital Macmillan Cancer Relief is in giving advice on treatments to control pain and conducting home visits. Macmillan also has a wing of Borders general hospital that is very user-friendly and pleasant. There are quiet rooms, treatment rooms and rooms for information. Most important of all, Macmillan takes away the fear and stigma of cancer—the C-word that people do not like to mention.

I used to work for the CABx, at times, when I was a lawyer. It was user-friendly, it was in the high street and it was free. However, nearly all the questions that I got were about benefits and housing problems, about which—after seven years' training and 12 years' practice as a lawyer—I knew nothing. Lawyers know hardly anything about benefits and we speak a funny language that nobody understands when we give answers. In the CABx, people get straightforward explanations. They are given forms and are helped with them.

To bring those two organisations together to deal with people who have a crisis in their lives, so that the burden can be taken off them, is worth while and to be commended throughout Scotland. Nevertheless, I endorse the comments that have been made about funding. CABx are not keeping their offices open all days of the week now, because of a lack of funding, although they do such a worthwhile, on-the-ground job. That must be addressed.

I am grateful for the briefing papers that I received from Macmillan Cancer Relief and the CABx. The Macmillan paper says:

"Our experience of supporting people affected by cancer has given us clear evidence that the financial needs of some patients and carers are poorly met" and that

"welfare benefits is a problem, with many people unaware that they may be entitled to support, or others who simply 'fail' the test of completing lengthy and complex forms."

Let us hear what the CABx say about the partnership operation. They say that in Lanarkshire alone,

"over 300 individuals have used the service".

Advice has been sought on 1,500 issues and £177,000 of benefits has now reached people who did not know they were entitled to them. That is what has been done just on that issue; I am sure that the partnership service is doing other things on housing and other issues.

I thoroughly commend the service. The first thing that I will do tomorrow is to ensure that it gets rolled out across parts of the south of Scotland, including the Borders and East Lothian. I see nothing but good in it. It is of such use to people and their families to know that they have medical support from Macmillan and support on all other issues from the expertise of the CABx.

Photo of Cathy Peattie Cathy Peattie Labour 5:35, 9 October 2003

I congratulate Karen Whitefield on lodging the motion for debate this evening. I also congratulate Macmillan Cancer Relief and the CABx on their excellent piece of work.

People talk about partnerships, but we could learn much from some of the partnerships in which voluntary organisations are involved up and down the country. The voluntary sector has the capacity to consider an issue and to work in partnership with others, not only in the voluntary sector, but in the health service and local authorities, to bridge a gap or to deal with an issue in a way that others have not been able to do. We underestimate the voluntary sector's ability to act quickly, to get rid of barriers, to sit down and consider an issue, to decide who the partners should be and then to work on it.

What happens in a family when a loved one is faced with cancer? There are all sorts of questions, and once people have got over the turmoil and the fear, they are left with basic questions. What does the illness mean, for the loved one and for the family? How do people offer support? How will the illness develop? How can people care? Who can help? How are we going to manage financially? Karen Whitefield highlighted what happens if someone has to give up work to care for another. How will they cope with the benefits?

People need clear information when they need it and they should not have to seek out that information. Families often struggle without that vital support, and that is why the Airdrie project sounds fantastic and why it is a good example of the kind of partnership that the voluntary sector is able to deliver.

Six years ago yesterday, I lost my mum. It is hard to stand here and talk about it. She had cancer and she was a determined old buddie—in fact, she was not that old. She was a nurse and there was no way that she was going to die in a hospital because that is not the place to die, she said. She was going to die at home. She lived on her own and I worked full time. My brother and I were the only ones who were there to care for her. We got past working out how we were going to support my mum and she decided that there was to be no daft therapy and all the rest of it; she knew that she was terminally ill and she wanted to be at home to make the best of the life that she had with her grandchildren around her.

How could I cope? I did not know where to go for the kind of support that we needed. Although I worked in the voluntary sector, I had never faced that kind of support need before. After speaking to organisations such as Crossroads, Marie Curie Cancer Care and the health service, I found that they were able to help me to identify the support that I would need initially to be able to go to work for some of the time and to be at home for my mum as well. Crossroads identified the care that would be needed to help support my mother. Local social services helped by looking at the adaptations that were available in the short term to help us to support her and to keep her at home.

What about the practical bit? People feel, "I am never going to be able to cope with this," so it is important to have people in the voluntary sector to offer help and support and to say, "Yes you can cope." It was not easy, but we coped because people helped us. At a time when people need support, it is important that there is not only practical support and clear advice on what the illness means to the family and the loved one, but practical advice on where to get help with benefits, adaptations and all the things that are needed to help children and families to deal with the crisis at hand. Partnership between the voluntary organisations is vital. We need to be creative in our support of the voluntary sector, but we cannot expect it to do what it does on a shoestring; that is not possible. The sector needs resources and I urge the minister to consider that.

Photo of Nanette Milne Nanette Milne Conservative 5:39, 9 October 2003

I welcome the debate and I join Karen Whitefield in commending the Lanarkshire initiative that provides services to cancer patients. I go further and suggest, like David Davidson, that not only would people in every health board area of Scotland benefit from a rolling-out of the service, but that all patients—not only those who suffer from cancer—would benefit significantly from such a service.

The Aberdeen citizens advice bureau has been running a successful advice clinic at Aberdeen royal infirmary for more than two years. The facility is available two days a week and follow-up home visits are carried out if possible. That has benefited many patients who are referred to the clinic by nurses, occupational therapists, consultants and other people who are concerned with the patients' care. Using the CABx to give advice on social welfare issues frees up the time of health care professionals to treat patients instead of filling in forms. Nurses and other hospital staff are very often not up to speed with benefit entitlements or with the complicated form-filling that is entailed. The CABx service relieves staff and their patients from a significant amount of stress, giving them more time to deal with health concerns. As has been said by several members, patients gain from having their non-medical problems dealt with; it relieves them of worry and aids their medical progress. Carers also benefit from the help that they get to deal with the practical concerns that they have to handle on behalf of patients.

Unfortunately, the health board in Aberdeen has withdrawn the £5,000 that it gave initially towards the £10,000 annual running cost of the service. The CAB there depends on charity on a year-by-year basis, without a partnership such as the Lanarkshire one that we are praising tonight. That means that the future of the clinic is not secure, and I would like to see that situation improved. On behalf of the Aberdeen CAB, I intend to raise the issue with Grampian NHS Board representatives at my next meeting with them in November, to see whether more secure funding arrangements can be arrived at. The model that we have heard being described tonight will be worth putting forward.

I am pleased to take part in today's debate, and I congratulate Macmillan Cancer Relief and the CABx in Lanarkshire on their partnership initiative. I shall certainly bring the Lanarkshire experience to the attention of those who matter in Aberdeen.

Photo of John Swinburne John Swinburne SSCUP 5:41, 9 October 2003

I thank Karen Whitefield for introducing a motion in this most compassionate field. Like many other members, I received all the briefing papers for this debate. When our youngest child went to school, my wife went to Hairmyres hospital to train as a nurse. She had general nursing experience and, in the last few years of her working life, she became a dedicated Marie Curie nurse and worked closely with Macmillan Cancer Relief. I took the briefing papers home and asked her to read them. She sat quietly and read through all the cases and said, "My God, what a step forward. Thank the people who are doing this." My wife's personal experience was that the Macmillan nurses had not only to cope with the medication, the syringe drivers and all the unfortunate things that are used to relieve the pain; they also had to try to cope with the paperwork that was involved in getting people the benefits that they were entitled to. She said that many of them were not up to speed in that area, although they were perfect in the medical area, and she had the feeling that many people were neglected financially through not being able to get the proper assistance.

The straightforward Lanarkshire scheme, involving people who are competent in the benefits field as well as people who are competent in the medical field, is a simple but unique example of co-operation between Macmillan and the CABx. It is not the case that the scheme should be implemented throughout the nation; it must be implemented throughout the nation. Although I am quite sure that by now his heart is in it, I implore Malcolm Chisholm to do everything that he can to have such schemes implemented throughout the nation for the good of anyone who is unfortunate enough to suffer in that manner. I thank Karen Whitefield again.

Photo of Malcolm Chisholm Malcolm Chisholm Labour 5:43, 9 October 2003

I congratulate Karen Whitefield on securing the debate and, like Cathie Craigie, I pay tribute to the part that she played in bringing about the important collaboration between Macmillan Cancer Relief and the CAB, which started in Airdrie and has expanded to the whole of Lanarkshire. I also thank and congratulate all the staff and volunteers who have been involved.

I know that we are all pleased that cancer mortality rates in Scotland are beginning to fall, as has been highlighted this week, but the corollary of that, particularly with an increasingly elderly population, is that more people are living with cancer. It is therefore more important than ever that we take a broad, holistic view of cancer care. That is what led me to announce in the cancer debate on 4 September a broadening of the important cancer scenarios work on mortality rates to encompass morbidity and the implications of living with cancer.

The provision of a service to people who are affected by cancer, by offering debt assistance and employment, housing and other benefit advice, is a valuable contribution to the overall support of people with cancer. The service benefits patients most of all, but it also benefits carers and indeed health professionals, as Donald Gorrie, David Davidson and John Swinburne pointed out. I am therefore happy to welcome and congratulate the new partnership between Macmillan Cancer Relief and the Lanarkshire CABx. I am aware that they plan to roll out the partnership into other areas and I wish them well in that.

The partnership with Macmillan Cancer Relief is only one example of the increasing role of the CAB service—as Shona Robison reminded us—in delivering advice in health settings. The CAB service currently delivers advice in over 200 locations across Scotland, which include more than 20 health care settings, ranging from general practitioner surgeries to clinics and from hospital sessions to home visits. For example, in the north-west Edinburgh local health care co-operative, CAB sessions in the GP surgery provide dedicated social and financial advice to patients and their carers.

I recognise and applaud the efforts of voluntary groups, which work tirelessly to provide support for people who are affected by cancer and, indeed, by any illness. That is why we are giving specific support to Voluntary Health Scotland to work with NHS boards to ensure their increasing involvement with the voluntary sector. Partnership and collaboration—with NHS Scotland, with the voluntary sector and with patients and their carers—are central to everything that we do and to the on-going successful implementation of "Cancer in Scotland: Action for Change".

In early September, I was invited to launch the Scottish cancer coalition: a partnership of cancer charities in Scotland, which have collaborated to form a new group. The coalition includes Macmillan Cancer Relief and I pay particular tribute to the enormously important work that that organisation carries out in a range of areas, such as carer schemes and the invaluable Macmillan nurses. I was pleased to have a useful meeting recently with the director in Scotland, Ian Gibson. We discussed cancer scenarios, patient involvement and a range of other issues. He also had a meeting recently with community care officials to discuss how Macmillan can play into the joint future agenda. We are providing him with the addresses of the joint future managers of local partnerships so that direct contact can be made with local decision makers. I hope that that will lead to further collaborations.

More generally, we applaud the voluntary sector collaboration that has resulted in the Scottish cancer coalition. The Scottish Executive looks forward to working with the coalition in the future, particularly but by no means exclusively in the key area of patient involvement.

Another good example of partnership and collaboration in practice is the new opportunities fund project in the Forth valley that is managed by Falkirk Council housing and social work service. That project, too, focuses on the provision of money advice to people with cancer and their families by providing advice on financial issues such as benefit entitlement and debt advice and by signposting other useful services that are provided by health and social work departments.

Social work involvement in managed clinical networks should be part and parcel of the provision of multidisciplinary services. Cancer is an excellent example of that. Networks aim to integrate health and social care; that is important if we are to be able to meet the holistic needs of people who are suffering from illness and its effects, whether cancer or any other debilitating disease.

The Scottish Executive's carers strategy recognises and values the huge contribution that carers make to the health and social care of thousands of people throughout Scotland. The Executive is committed to ensuring that carers are better supported than they have ever been before. The resources that are given to local authorities to support carers have risen from £5 million a year in 1999-2000 to £21 million this year.

We recognise the very special difficulties that people with serious illnesses such as cancer face and the strains that those illnesses cause for those people and their carers. We support the innovative work by Macmillan Cancer Relief and the citizens advice bureaux to address problems that cancer patients and their carers face and we applaud their contribution to helping many people to cope better with their illnesses and their lives.

Patients' difficulties in getting the information that they need, in the format that is best suited to them and at the time when they need it, is an issue that arises time and again. There are many options for resolving that problem, such as using textbooks, booklets, brochures and videos. Earlier this year I launched a Cancer in Scotland publication called, "A Guide to Securing Access to Information", which highlights the frequently asked questions from people who are affected by cancer as they progress through the patient pathway. The document also highlights areas where there are information needs, including clinical, practical, emotional and financial needs. The document sets the wider strategic picture that surrounds patient information and asks NHS boards and regional cancer advisory groups to focus on whether local patient information strategies meet the specific needs of people affected by cancer.

Photo of Christine Grahame Christine Grahame Scottish National Party

I hope that at some point the minister will address the matter of the funding of CABx, which are under pressure. I believe that there is consensus among members on that point. I do not necessarily expect an answer now, but I hope that the issue will be addressed. If the collaborative idea that we are discussing is an excellent one, we must find the money to fund it.

Photo of Malcolm Chisholm Malcolm Chisholm Labour

I recognise that a series of funding issues arose in the debate, with reference to CABx, support of the voluntary sector, local authorities and health. I will not make any funding announcements in this debate, but I recognise that funding is crucial for that collaborative work. Christine Grahame will know of the significant investment that we are putting into the cancer strategy. However, the important aspect is to build genuine partnerships and collaboration, because at the moment the bulk of the cancer money goes into other areas.

It is important that those with cancer have access to accurate and timeous information and to the support services that they need to help them continue with their lives in as normal a manner as possible. Our work on providing information links up with the specific initiative that we are discussing.

I thank Karen Whitefield for reminding me of my comments on Tuesday. As I said, there are undoubtedly initiatives throughout Scotland that can be adopted and adapted for local use. The collaboration between Macmillan and Lanarkshire CABx is undoubtedly in that category.

I pay tribute to everyone involved in cancer services in Scotland, but particularly to those who work in the Macmillan and Lanarkshire CABx initiative, which demonstrates that by working collaboratively and in partnership we can secure real and lasting improvements in services for people with cancer.

Meeting closed at 17:52.